DE3146628C2 - Trigger device for shock waves for therapeutic purposes - Google Patents

Trigger device for shock waves for therapeutic purposes

Info

Publication number
DE3146628C2
DE3146628C2 DE3146628A DE3146628A DE3146628C2 DE 3146628 C2 DE3146628 C2 DE 3146628C2 DE 3146628 A DE3146628 A DE 3146628A DE 3146628 A DE3146628 A DE 3146628A DE 3146628 C2 DE3146628 C2 DE 3146628C2
Authority
DE
Germany
Prior art keywords
shock
trigger
wave
pulse
shock waves
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
DE3146628A
Other languages
German (de)
Other versions
DE3146628A1 (en
Inventor
Klaus van Prof. Dr. 8035 Gauting Ackern
Christian Prof. Dr. 8034 Germering Chaussy
Bernd Dr. 7990 Friedrichshafen Forssmann
Wolfgang Dr. 7997 Immenstaad Hepp
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dornier Medizintechnik GmbH
Original Assignee
Dornier System GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=6147126&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=DE3146628(C2) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by Dornier System GmbH filed Critical Dornier System GmbH
Priority to DE3146628A priority Critical patent/DE3146628C2/en
Priority to EP82108967A priority patent/EP0081051B2/en
Priority to JP57184762A priority patent/JPS58130034A/en
Publication of DE3146628A1 publication Critical patent/DE3146628A1/en
Priority to US06/894,739 priority patent/US4685461A/en
Priority to US07/083,196 priority patent/US4745920A/en
Application granted granted Critical
Publication of DE3146628C2 publication Critical patent/DE3146628C2/en
Expired legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
    • A61B2017/00699—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body correcting for movement caused by respiration, e.g. by triggering
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
    • A61B2017/00703—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body correcting for movement of heart, e.g. ECG-triggered

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

Auslösevorrichtung für Stoßwellen zu therapeutischen Zwecken, insbesondere zur Zerkleinerung von Nierensteinen, dadurch gekennzeichnet, daß die Stoßwellen mit der R-Zacke des EKG oder mit einer vorwählbaren zeitlichen Verzögerung danach ausgelöst werden.Triggering device for shock waves for therapeutic purposes, in particular for comminuting kidney stones, characterized in that the shock waves are triggered with the R-wave of the EKG or with a preselectable time delay thereafter.

Claims (5)

1 2 Körperfunktionen korreliert, daß die Körperfunktionen Patentansprüche: nicht gestört werden und/oder die Effektivität der Stoß- wellenbehandlung gesteigert wird.1 2 body functions correlates that the body functions patent claims: are not disturbed and / or the effectiveness of the shock wave treatment is increased. 1. Auslösevorrichtung für Stoßwellen zu thera- Die Aufgabe wird erfindungsgemäß gelöst durch eine peutischen Zwecken, insbesondere zur Zerkleine- s Voi.ichtung mit den im Anspruch 1 genannten Merkrung von Nierensteinen, dadurch gekenn- malen. 1. Triggering device for shock waves for therapy The object is achieved according to the invention by a therapeutic purpose, in particular for crushing s Voi.ichtung with the noted in claim 1 of kidney stones, characterized thereby. zeichnet, daß sie Weitere Ausgestaltungen der Erfindung sind in denrecords that they are further embodiments of the invention in the Unteransprüchen angegeben.Subclaims indicated. a) einen Meßwertaufnehmer für eine periodische Ein Vorteil dieser Erfindung ist, daß auch bei kreis-Körperfunktion, . io laufgefährdeten Patienten Stoßwellen angewandt wer-a) a transducer for a periodic An advantage of this invention is that even with circular body function, . shock waves are applied to patients at risk of running b) eine Schaltung, die aus einem Extremwert der den können und dadurch auch bei dieser Patientengrup-Funktion einen Triggerimpuls gewinnt, pe auf operative Eingriffe verzichtet werden kann. Dieb) a circuit that is made up of an extreme value of the can and thus also with this patient group function gains a trigger impulse so that surgical interventions can be dispensed with. the c) eine einstellbare Verzögerungseinrichtung und automatische zeitliche Korrelation mit dem Herzschlagc) an adjustable delay device and automatic time correlation with the heartbeat d) einsn manuellen Freigabeschalter für die Wei- oder mit weiteren Körperfunktionen nimmt dem behanterleiiung des Triggerimpulses zur Stoßwellen- 15 delnden Arzt die Aufgabe ab, die Applikation der Stoßquelle wellen den Körperrhythmen anzupassen. Fehlentscheidungen können dadurch vermieden werden. d) A manual release switch for the white or with other bodily functions relieves the handling of the trigger impulse to the shockwave doctor from the task of adapting the application of the shock source waves to the body rhythms. Wrong decisions can thus be avoided. enthält. Anhand zweier Figuren wird die Erfindung näher be-contains. The invention is described in more detail with the aid of two figures 2. Auslösevorrichtung nach Anspruch 1, dadurch schrieben.2. Tripping device according to claim 1, characterized in writing. gekennzeichnet, daß sie Meßwertaufnehmer, Trig- 20 Die Fig. I zeigt den zeitlichen Verlauf der Spannun-characterized in that they are measured value transducers, Trig- 20 Fig. I shows the time course of the voltage gerschaltu.igen und Verzögerungseinrichtungen für gen des EKG bei normalem Herzschlag. Die Bezeich-Switching and delay devices for the ECG gene with a normal heartbeat. The designation mehrere periodische Körperfunktionen sowie ein nungen P, Q, R, S, T für die Zacken sind in der Medizinseveral periodic body functions as well as a P, Q, R, S, T for the spikes are in medicine »Und«-Gatter enthält, welches bei gleichzeitigem gebräuchlich. Der steilste Anstieg ist die R-ZackeContains the "and" gate , which is used at the same time. The steepest ascent is the R peak Eintreffen der Impulse aller Triggerschaltungen ei- (Punkt 1). Punkt 2 zeigt einen gefahrlosen Auslösezeit-Arrival of the impulses from all trigger circuits (point 1). Point 2 shows a safe release time nen Impuls zu dem manuellen Freigabeschalter 25 punkt für eine Stoßwellenapplikation. Das EKG wird inNEN pulse to the manual release switch 25 point for a shock wave application. The EKG is in durchläßt bekannter Weise aufgenommen, aus dem Anstieg derpasses through known manner absorbed, from the increase in 3. Auslösevorrichtung nach Anspruch 1, dadurch R-Zacke 1 wird in ebenfalls bekannter Weise ein Triggekennzeichnet, daß als Meßwertaufnehmer eine gerimpuls gewonnen und auf eine Verzögerungseinrich-EKG-Sonde verwendet wird, wobei der Extremwert tung geschickt Diese ist im Bereich von 0 bis 100 msec die R-Zacke des EKG ist 30 einstellbar und gibt nach der vom Arzt vorgewählten3. Triggering device according to claim 1, characterized in that R-wave 1 is also identified as a trigger, that as a transducer a gerimpuls obtained and on a delay device EKG probe is used, with the extreme value sent. This is in the range from 0 to 100 msec the R-wave of the EKG is adjustable 30 and gives according to the preselected by the doctor 4. Auslösevorrichtung nach Anspruch 1, dadurch Zeit (Abstand 1—2) einen Auslöseimpuls auf die Fungekennzeichnet, daß als Meßwertaufnehmer ein Spi- kenstrecke, wodurch diese zündet und eine Stoßwelle rometer verwendet wird, wobei als Extremwert die erzeugt.4. Triggering device according to claim 1, characterized in that time (interval 1–2) a triggering pulse to the fungus indicates that a spike path is used as the transducer, causing it to ignite and a shock wave rometer is used, with the generated as the extreme value. Phase des ausgeatmeten Zustands verwendet wird. Die F i g. 2 zeigt das Blockschaltbild einer Vorrich-Exhaled phase is used. The F i g. 2 shows the block diagram of a device 5. Auslösevorrichtung nach Anspruch 1, dadurch 35 tung mit weitergehender Automatisierung durch Begekennzeichnet, daß die Schaltung aus jedem zwei- rücksichtigung einer zweiten Körperfunktion, hier der ten, dritten usw. Extremwert einen Triggerimpuls Atmung. Zwei Meßwertaufnehmer, Aufnehmer 3 für gewinnt. das EKG, Aufnehmer 4 für die Atembewegung, geben5. tripping device according to claim 1, characterized in 35 device with further automation by be marked, that the circuit from each two takes into account a second body function, here the th, third, etc. extreme value a trigger pulse breathing. Two transducers, transducer 3 for wins. give the EKG, transducer 4 for the breathing movement ihre Meßwerte an je einen Impulsgenerator 5,6. Diesetheir measured values to a pulse generator 5,6 each. These 40 Generatoren sind so einstellbar, daß sie auf eine bestimmte Phase der Meßwerte hin, z.B. 10msec nach dem A.if treten der R-Zacke oder im Moment des Atem-40 generators can be set in such a way that they respond to a certain phase of the measured values, e.g. 10msec after the A.if occur the R-wave or at the moment of breathing Die Erfindung betrifft eine Auslösevorrichtung für Stillstandes, einen Impuls geben. Die Impulsgeneratoren Stoßwellen zu therapeutischen Zwecken, insbesondere sind an c'ie Eingänge eines »Und«-Gatters 7 angeschloszur Zerkleinerung von Nierensteinen. 45 sen. Der Ausgang des »Und«-Gatters 7 führt über einenThe invention relates to a release device for standstill, give a pulse. The pulse generators Shock waves for therapeutic purposes, in particular, are connected to the inputs of an "and" gate 7 Crushing kidney stones. 45 sen. The exit of the "and" gate 7 leads through one Bekannt ist ein Gerät zur berührungslosen Zerkleine- manuellen Schalter 8 zur Funkenstrecke, rung von Konkrementen in Körpern von Lebewesen Ein Auslöseimpuls erreicht die Funkenstrecke alsoA device for contactless shredding - manual switch 8 for spark gap is known, tion of concretions in the bodies of living beings A trigger pulse thus reaches the spark gap mittels Stoßwellen (DE-PS 23 51 247). Dabei werden au- nur, wenn
ßerhalb des Körpers durch elektrische Entladungen einer Unterwasserfunkenstrecke in einer Fokussierungs- 50 a) der Arzt den Schalter 8 geschlossen hält, kammer Stoßwellen erzeugt, die auf das Konkrement b) die Atmungsbewegung gerade ruht, fokussiert werden und dieses zerkleinern. Diese Stoß- c) die R-Zacke des EKG gerade aufgetreten ist. wellen durchdringen das Körpergewebe ohne Schädigungen zu verursachen. Möglich ist dabei allerdings die Die Berücksichtigung weiterer Körperfunktionen so-Auslösung von Extrasystolen in der erregbaren Phase 55 wie das schnell aufeinanderfolgende Auslösen mehrerer des Herzschlages. Bei kreislaufgcfährdeten Patienten Stoßwellen ist möglich.by means of shock waves (DE-PS 23 51 247). Only if
ßerhalb the body through electrical discharges from an underwater spark gap in a focusing 50 a) the doctor keeps the switch 8 closed, chamber creates shock waves that rest on the concrement b) the breathing movement is just focused and crushed it. This burst- c) the R-wave of the EKG has just occurred. waves penetrate the body tissue without causing damage. It is possible, however, to take additional body functions into account in such a way as to trigger extrasystoles in the excitable phase 55, such as triggering several heartbeats in rapid succession. Shock waves are possible in circulatory endangered patients. kann dadurch der Herzrhythmus gestört werden. Eine .this can disrupt the heart rhythm. One . ausreichende Blutumwälzung ist dann nicht mehr ge- Hierzu 1 Blatt ZeichnungenSufficient blood circulation is then no longer required. 1 sheet of drawings währleistet. ensures. Zusätzlich ist bei der Wahl des Auslösezeitpunktes 60
darauf zu achten, daß die Koordinaten des Zielobjektes,
z. B. der Niere, die durch die Atmung periodisch geändert werden, im Augenblick der Stoßauslösung möglichst konstant sind, um eine hohe Treffwahrscheinlichkeit zu erreichen. 65In addition, when choosing the trigger time, 60
make sure that the coordinates of the target object,
z. B. the kidneys, which are periodically changed by breathing, are as constant as possible at the moment of the shock release in order to achieve a high probability of impact. 65 Der Erfindung liegt die Aufgabe zugrunde, eine Vorrichtung zu schaffen, die den Zeitpunkt der Stoßwellenauslösung so mit einer oder mehreren periodischenThe invention is based on the object of creating a device that determines the point in time when the shock wave is triggered so with one or more periodic
DE3146628A 1981-11-25 1981-11-25 Trigger device for shock waves for therapeutic purposes Expired DE3146628C2 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
DE3146628A DE3146628C2 (en) 1981-11-25 1981-11-25 Trigger device for shock waves for therapeutic purposes
EP82108967A EP0081051B2 (en) 1981-11-25 1982-09-28 Releasing device for shock waves for therapeutic purposes
JP57184762A JPS58130034A (en) 1981-11-25 1982-10-22 Medical impact wave injecting apparatus
US06/894,739 US4685461A (en) 1981-11-25 1986-08-11 Apparatus and method for triggering shock waves in lithotripsy
US07/083,196 US4745920A (en) 1981-11-25 1987-08-10 Apparatus and method for triggering therapeutic shock waves

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE3146628A DE3146628C2 (en) 1981-11-25 1981-11-25 Trigger device for shock waves for therapeutic purposes

Publications (2)

Publication Number Publication Date
DE3146628A1 DE3146628A1 (en) 1983-06-01
DE3146628C2 true DE3146628C2 (en) 1991-03-28

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ID=6147126

Family Applications (1)

Application Number Title Priority Date Filing Date
DE3146628A Expired DE3146628C2 (en) 1981-11-25 1981-11-25 Trigger device for shock waves for therapeutic purposes

Country Status (4)

Country Link
US (2) US4685461A (en)
EP (1) EP0081051B2 (en)
JP (1) JPS58130034A (en)
DE (1) DE3146628C2 (en)

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DE3720826C1 (en) * 1987-06-24 1988-12-22 Dornier Medizintechnik Device for the breath-triggered therapeutic treatment of living beings with shock waves
DE4241161A1 (en) * 1992-12-07 1994-06-09 Siemens Ag High power focussed acoustic pulse generator for clinical use - has pressure sensors for determining spatial position of treated region as function of time, electric motors for adjusting focus of acoustic waves to area to be treated over three=dimensional coordinates, and fuzzy logic controller
EP2628456A1 (en) 2012-02-15 2013-08-21 Dornier Med Tech Systems GmbH Shock wave therapy device with dynamic target tracking

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US6056742A (en) * 1997-02-03 2000-05-02 Eclipse Surgical Technologies, Inc. Revascularization with laser outputs
US5993443A (en) * 1997-02-03 1999-11-30 Eclipse Surgical Technologies, Inc. Revascularization with heartbeat verification
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US6370419B2 (en) * 1998-02-20 2002-04-09 University Of Florida Method and apparatus for triggering an event at a desired point in the breathing cycle
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Publication number Priority date Publication date Assignee Title
DE3720826C1 (en) * 1987-06-24 1988-12-22 Dornier Medizintechnik Device for the breath-triggered therapeutic treatment of living beings with shock waves
DE4241161A1 (en) * 1992-12-07 1994-06-09 Siemens Ag High power focussed acoustic pulse generator for clinical use - has pressure sensors for determining spatial position of treated region as function of time, electric motors for adjusting focus of acoustic waves to area to be treated over three=dimensional coordinates, and fuzzy logic controller
EP2628456A1 (en) 2012-02-15 2013-08-21 Dornier Med Tech Systems GmbH Shock wave therapy device with dynamic target tracking

Also Published As

Publication number Publication date
US4745920A (en) 1988-05-24
EP0081051A1 (en) 1983-06-15
EP0081051B1 (en) 1986-02-12
JPS58130034A (en) 1983-08-03
EP0081051B2 (en) 1991-04-17
US4685461A (en) 1987-08-11
JPS618686B2 (en) 1986-03-17
DE3146628A1 (en) 1983-06-01

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